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LISA J SAMSON-FANG MD
NPI 1821188442
Pediatrics - Developmental - Behavioral Pediatrics in Salt Lake City, UT

Active since October 13, 2006PECOS Enrolled
50 N MEDICAL DR, SALT LAKE CITY, UT 84132(801) 581-3501 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Lisa J Samson-fang Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA J SAMSON-FANG MD (NPI 1821188442) is an individual developmental - behavioral pediatrics provider in Salt Lake City, Utah, licensed in Utah (360059-1205) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821188442
Entity TypeIndividualFemale
Primary Taxonomy2080P0006X
Provider Legal NameLISA J SAMSON-FANGCredential: MD
Location Address50 N MEDICAL DRSalt Lake City, UT 84132-0001
Mailing AddressPo Box 581100Salt Lake City, UT 84158-1100 · (801) 213-3800
Phone(801) 581-3501
Sole ProprietorNo
Enumeration DateOctober 13, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1821188442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080P0006X
License✔ Licensed in UT · 360059-1205
Definition
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
50 N MEDICAL DR, Salt Lake City, UT 84132
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Select Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa J Samson-fang Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Lisa Samson-fang reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ihc Health Services Inc
0.1 mi
Pediatric Radiology
100 MARIO CAPECCHI DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 3,691 clinicians in this Medicare group
NPI 1053664680 (801) 442-3156
Shriners Hospitals For Children
0.8 mi
Pediatric Orthopaedic Surgery
1275 E FAIRFAX RD
Salt Lake City, UT 84103
  • Reassigned Medicare billing, Utah enrollment
  • 28 clinicians in this Medicare group
NPI 1396187282 (801) 536-3714

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY OF UTAH ADULT SERVICES
Otolaryngology
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 587-6336
ADAM PORTER MOTR/L
Occupational Therapist
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-2119
DR. ERICA JANE ALEXANDRA COLVIN MD
Emergency Medicine
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
MEGAN MEIER MD
Internal Medicine (Rheumatology)
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
STACI LEE GUNTER PA-C
Physician Assistant (Surgical)
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6908
MATTHEW D. O'DELL MD
Internal Medicine
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7899
WATARU HORIGUCHI
Student in an Organized Health Care Education/Training Program
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
JEANELLE WEBB
Registered Nurse
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (925) 510-0868

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Samson-fang's NPI number?

The NPI number for Lisa Samson-fang is 1821188442. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is Lisa Samson-fang located?

Lisa Samson-fang practices at 50 N Medical Dr, Salt Lake City, UT 84132. The listed phone number is (801) 581-3501.

What is Lisa Samson-fang's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Is Lisa Samson-fang enrolled in Medicare?

Yes. Lisa Samson-fang is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Lisa Samson-fang's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Samson-fang reassigns Medicare benefits to 2 organizations: Ihc Health Services Inc (Salt Lake City, UT) and Shriners Hospitals For Children (Salt Lake City, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Samson-fang's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Samson-fang accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Select Health and University of Utah Health Plans list Lisa Samson-fang as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Samson-fang was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.